1例亚胺培南西司他丁钠引发药物热的诊断

Diagnosis of the Drug Fever Caused by Imipenem/Cilastatin

目的探讨药物热的发病机制、临床特点及诊疗要点,以提高临床医生和临床药师对药物热的早期识别,减轻患者痛苦,降低医院费用。方法对1例肾结石激光碎石术后持续发热的病例诊疗进行分析。结果患者术后感染性休克,予亚胺培南西司他丁钠0. 5 g q6h抗感染8 d,体温好转,3 d后体温再次升高,加强抗感染治疗无效,停用所有抗菌药后体温正常,证实为亚胺培南西司他丁钠所致药物热。结论药物热机制复杂,临床表现多样。临床医生及临床药师加强对药物热的早期识别,有助于减轻患者痛苦,降低医疗成本。

Ojbective To explore the pathogenesis,clinical features and diagnosis and treatment of drug fever,to improve the early identification of drug fever by clinicians and clinical pharmacists,reduce patient suffering and reduce hospital costs.Methods One case of diagnosis and treatment of persistent fever after renal lithotripsy laser lithotripsy was analyzed.Results After septic shock,imipenem/cilastatin0.5g q6h was anti-infected for8days,the body temperature improved,and the body temperature increased again after3days.The anti-infective treatment was ineffective,and the body temperature was normal after all antibiotics were stopped.It was confirmed to be the drug fever caused by imipenem/cilastatin.Conclusion The drug thermal mechanism is complex and the clinical manifestations are diverse.Clinicians and clinical pharmacists enhance early identification of drug heat,helping to alleviate patient suffering and reduce medical costs.